Crohn’s disease is a chronic inflammatory condition that can affect any part of the digestive tract, including the mouth. Mouth sores are a common symptom for many individuals with Crohn’s disease, sometimes appearing before intestinal symptoms. These oral manifestations can impact daily life.
Identifying Crohn’s Mouth Sores
Crohn’s mouth sores often resemble aphthous ulcers (canker sores), but they have specific distinguishing features. These ulcers are typically shallow and painful, with a yellowish or gray center surrounded by a reddish border. They vary in size, from pinpoint lesions to larger ulcers, and may appear individually or in clusters.
Other specific oral signs of Crohn’s disease include cobblestoning of the oral mucosa. This involves raised bumps or folds that give the inner lining of the cheeks and lips a cobblestone-like texture. Deep, linear ulcers are another characteristic, often long and narrow, found in the fold between the cheek and gum, sometimes with thickened margins. Mucosal tags, small, fleshy lumps, can also develop.
Common Locations and Types
Crohn’s mouth sores frequently appear in specific areas within the oral cavity. These include the inner surfaces of the lips and cheeks, the gums, and sometimes the tongue, soft palate, or the back of the throat.
A rarer oral manifestation is pyostomatitis vegetans. This condition presents as multiple yellow or white pustules that may rupture, forming superficial ulcers often described as “snail tracks” due to their fissured appearance. The oral mucosa might also appear thickened and granular. Other associated changes include lip swelling, angular cheilitis (cracking at mouth corners), and gum redness and swelling.
Distinguishing from Other Mouth Sores
Distinguishing Crohn’s mouth sores from other common oral conditions is important. Crohn’s-related aphthous ulcers resemble common canker sores (round or oval with a red border and yellow/gray center), but are often more frequent, persistent, and severe. They typically worsen during Crohn’s flare-ups. The presence of other specific oral signs like cobblestoning or linear ulcers can also indicate Crohn’s.
Cold sores, caused by the herpes simplex virus, differ. They appear as fluid-filled blisters that crust over, usually on the outside of the mouth (lips), unlike Crohn’s sores which are internal ulcers. Cold sores are contagious, unlike Crohn’s mouth sores.
Oral thrush (candidiasis) is another distinct condition, characterized by creamy white patches that can be scraped off, revealing red, irritated tissue. This is a fungal infection, not an ulceration. Geographic tongue, sometimes associated with Crohn’s, involves migratory, map-like patterns on the tongue’s surface, distinct from ulcerative lesions.
When to Seek Medical Advice
If mouth sores are persistent, frequently recurring, or interfere with daily activities such as eating, drinking, or speaking, consulting a healthcare professional is advisable. These symptoms may signal an underlying issue. Seeking evaluation is important if mouth sores appear alongside other symptoms commonly associated with Crohn’s disease, such as abdominal pain, chronic diarrhea, unexplained weight loss, fever, or fatigue.
A doctor can determine if the oral lesions are related to Crohn’s disease or another condition. Self-diagnosis is not recommended, as a thorough medical evaluation, potentially including further investigations, is necessary for an accurate diagnosis and appropriate management plan.